Polymyalgia rheumatica

Overview

Polymyalgia rheumatica is an inflammatory condition that causes pain and stiffness in the neck, shoulders, and hips, mainly in people over 50. Symptoms typically start off fast and get worse in the morning or after inactivity. Morning stiffness typically persists for at least 30 minutes or longer. While the pain can be severe, it may ease with movement.

Polymyalgia rheumatica is associated with another inflammatory condition known as giant cell arteritis. About 10% to 20% of people with polymyalgia rheumatica may also have giant cell arteritis. Giant cell arteritis causes headaches, blurred vision, jaw pain, and tenderness on the scalp.

Symptoms

Polymyalgia rheumatica typically presents with sudden pain and stiffness in large joints, notably shoulders and hips, but can also affect neck, arms, back, and buttocks, often appearing within two weeks, sometimes overnight, and typically impacting both sides of the body.

Other common signs and symptoms include:

• Stiffness in the affected areas, particularly in the morning or after rest
• Restricted mobility in affected parts
• Stiffness, or pain in the knees, elbows, or wrists
• Weakness
• Overall malaise, or general sense of illness
• Low-grade fever
• Depression
• Decreased appetite
• Weight loss

If any of the signs and symptoms persist, consult a healthcare provider for proper diagnosis and treatment. Medical consultation is also necessary if one experiences new aches, pains, or stiffness that disrupt sleep or hinder one’s ability to perform daily tasks like getting dressed.

Since polymyalgia rheumatica and giant cell arteritis have overlapping symptoms, consult a healthcare provider if headaches, vision changes, fever, fatigue, loss of appetite, jaw pain, or tenderness around the scalp is experienced.

Causes

The exact origins of polymyalgia rheumatica remain uncertain, although researchers have suggested various theories. These encompass autoimmune disease, where the immune system erroneously targets the body, inflammation of sacs in the hips or shoulders, referred to as bursitis, and the effects of aging.

Other identified potential causes include:

• Heredity: The risk to polymyalgia rheumatic is often influenced by some genetic factors.
• Environmental exposure: Polymyalgia rheumatica has not been associated with any specific viral infection. However, many cases exhibit cyclical patterns and potential seasonal variations, suggesting a possible involvement of a virus or other environmental trigger.
• Giant cell arteritis: Polymyalgia rheumatica and giant cell arteritis often coexist and share similar symptoms. Giant cell arteritis causes inflammation in artery linings, especially in temples, leading to headaches, jaw pain, vision issues, and scalp tenderness. Without treatment, it can cause serious complications like stroke or blindness.

Risk factors

Although the exact cause of polymyalgia rheumatica is unknown, several risk factors were identified, such as:

• Age: It is most common in those who are 70 to 80 years old. Generally, as people age, the risk also increases.
• Sex: Polymyalgia rheumatica is more common in women than in men.
• Ethnic and racial background: Compared to any other ethnic or racial group, Caucasians, particularly those with Northern European origin are more susceptible to the disease.